Jonathan Ciron1, Alvaro Cobo-Calvo2, Bertrand Audoin3, Bertrand Bourre4, David Brassat1, Mikael Cohen5, Nicolas Collongues6, Romain Deschamps7, Françoise Durand-Dubief8, David Laplaud9, Elisabeth Maillart10, Caroline Papeix10, Hélène Zephir11, Matthieu Bereau12, Bruno Brochet13, Clarisse Carra-Dallière14, Nathalie Derache15, Clarisse Gagou-Scherer16, Carole Henry17, Philippe Kerschen18, Guillaume Mathey19, Nicolas Maubeuge20, Aude Maurousset21, Alexis Montcuquet22, Thibault Moreau23, Christophe Prat24, Frédéric Taithe25, Eric Thouvenot26, Ayman Tourbah27, Fabien Rollot28, Sandra Vukusic29, Romain Marignier30. 1. Department of Neurology, Centre de Ressources et Compétences Sclérose en Plaques, Toulouse University Hospital, Toulouse, France. 2. Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Lyon, France; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle and INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France. 3. Department of Neurology, Hôpital de La Timone, APHM, Marseille, France; Aix-Marseille University, Marseille, France. 4. Department of Neurology, Rouen University Hospital, Rouen, France. 5. Centre de Ressources et Compétences SEP, Neurologie, Université Nice Côte d'Azur, CHU Pasteur 2, Nice, France. 6. Department of Neurology, Strasbourg University Hospital, Strasbourg, France. 7. Department of Neurology, Fondation A. De Rothschild, Paris, France. 8. Department of Neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France. 9. Department of Neurology, Nantes University Hospital, Nantes, France. 10. Department of Neurology, Pitié-Salpêtrière Hospital, APHP, Paris, France. 11. Department of Neurology, Lille University Hospital, Lille, France; LIRIC UMR 995, Lille, France. 12. Department of Neurology, Besançon University Hospital, Besançon, France. 13. Department of Neurology, Bordeaux University Hospital, Bordeaux, France. 14. Department of Neurology, Montpellier University Hospital, Montpellier, France. 15. Department of Neurology, Caen University Hospital, Caen, France. 16. Department of Neurology, Angers University Hospital, Angers, France. 17. Department of Neurology, Paris Saint-Denis Hospital, Paris, France. 18. Department of Neurology, Centre Hospitalier Luxembourg, Luxembourg. 19. Department of Neurology, Nancy University Hospital, Nancy, France. 20. Department of Neurology, Poitiers University Hospital, Poitiers, France. 21. Department of Neurology, Tours University Hospital, Tours, France. 22. Department of Neurology, Limoges University Hospital, Limoges, France. 23. Department of Neurology, Dijon University Hospital, Dijon, France. 24. Department of Neurology, Angoulême Hospital, Angoulême, France. 25. Department of Neurology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. 26. Department of Neurology, Nîmes University Hospital, Nîmes, France. 27. CHU de Reims and Université Reims Champagne Ardenne, LPN, EA 2027 Université Paris 8, Saint-Denis, France. 28. Claude Bernard Lyon 1 University, Villeurbanne, France. 29. Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Bron, France; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle and INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France. 30. Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Bron, France; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle and INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France.
Abstract
OBJECTIVES: We aim to (1) determine the frequency and distinctive features of short myelitis (SM) and longitudinally extensive transverse myelitis (LETM) in a cohort of adults with myelin oligodendrocyte glycoprotein (MOG)-antibody (Ab)-associated myelitis and (2) determine baseline prognostic factors among MOG-Ab-positive patients whose disease started with myelitis. MATERIAL AND METHODS: We retrospectively analyzed clinical and paraclinical variables from a multicentric French cohort of adults with MOG-Ab-associated myelitis. At last follow-up, patients were classified into two groups according to the severity of the Expanded Disability Status Scale (EDSS) as ⩽2.5 or ⩾3.0. RESULTS: Seventy-three patients with at least one episode of myelitis over disease course were included; among them, 28 (38.4%) presented with SM at the time of the first myelitis. Motor and sphincter involvement was less frequently observed in SM (51.9% and 48.2%, respectively) than in LETM patients (83.3% and 78.6%, respectively), p = 0.007 and p = 0.017; 61% of LETM patients displayed brain lesions compared to 28.6% in the SM group, p = 0.008, and the thoracic segment was more frequently involved in the LETM (82.2%) than in the SM group (39.3%), p < 0.001. EDSS at last follow-up was higher in LETM (median 3.0 (interquartile range: 2.0-4.0)) compared to SM patients (2.0, (1.0-3.0)), p = 0.042. Finally, a higher EDSS at onset was identified as the only independent risk factor for EDSS ⩾3.0 (odds ratio, 1.40, 95% confidence interval (CI): 1.01-1.95, p = 0.046). CONCLUSION: SM in MOG-Ab-associated disease is not rare. The severity at onset was the only independent factor related to the final prognosis in MOG-Ab-associated myelitis.
OBJECTIVES: We aim to (1) determine the frequency and distinctive features of short myelitis (SM) and longitudinally extensive transverse myelitis (LETM) in a cohort of adults with myelin oligodendrocyte glycoprotein (MOG)-antibody (Ab)-associated myelitis and (2) determine baseline prognostic factors among MOG-Ab-positive patients whose disease started with myelitis. MATERIAL AND METHODS: We retrospectively analyzed clinical and paraclinical variables from a multicentric French cohort of adults with MOG-Ab-associated myelitis. At last follow-up, patients were classified into two groups according to the severity of the Expanded Disability Status Scale (EDSS) as ⩽2.5 or ⩾3.0. RESULTS: Seventy-three patients with at least one episode of myelitis over disease course were included; among them, 28 (38.4%) presented with SM at the time of the first myelitis. Motor and sphincter involvement was less frequently observed in SM (51.9% and 48.2%, respectively) than in LETM patients (83.3% and 78.6%, respectively), p = 0.007 and p = 0.017; 61% of LETM patients displayed brain lesions compared to 28.6% in the SM group, p = 0.008, and the thoracic segment was more frequently involved in the LETM (82.2%) than in the SM group (39.3%), p < 0.001. EDSS at last follow-up was higher in LETM (median 3.0 (interquartile range: 2.0-4.0)) compared to SM patients (2.0, (1.0-3.0)), p = 0.042. Finally, a higher EDSS at onset was identified as the only independent risk factor for EDSS ⩾3.0 (odds ratio, 1.40, 95% confidence interval (CI): 1.01-1.95, p = 0.046). CONCLUSION: SM in MOG-Ab-associated disease is not rare. The severity at onset was the only independent factor related to the final prognosis in MOG-Ab-associated myelitis.